TY - JOUR
T1 - Effect of Marijuana Smoking on Pulmonary Disease in HIV-Infected and Uninfected Men
T2 - A Longitudinal Cohort Study
AU - Lorenz, David R.
AU - Uno, Hajime
AU - Wolinsky, Steven M.
AU - Gabuzda, Dana
N1 - Funding Information:
This study was supported by NIH grants to D.G. (R01 DA030985 and DA046203 ) and in part by NIH funding to the Northwestern University Clinical Research Unit of the MACS (U01 - AI35039 , with additional co-funding from National Cancer Institute (NCI) and National Institute on Drug Abuse (NIDA)). The MACS is funded by the National Institute of Allergy and Infectious Diseases (NIAID; U01-AI35039 , U01-AI35040 , U01-AI35041 , U01-AI35042 , and UM1-AI35043 ), with additional co-funding from the National Cancer Institute (NCI), National Institute on Drug Abuse (NIDA), and National Institute of Mental Health (NIMH) at the National Institutes of Health (NIH). MACS data collection is also supported by UL1-TR000424 ( JHU CTSA). The study funders had no role in study design, data collection, analysis, or interpretation, or writing of this report.
Funding Information:
U.S. National Institutes of Health.This study was supported by NIH grants to D.G. (R01 DA030985 and DA046203) and in part by NIH funding to the Northwestern University Clinical Research Unit of the MACS (U01 - AI35039, with additional co-funding from National Cancer Institute (NCI) and National Institute on Drug Abuse (NIDA)). The MACS is funded by the National Institute of Allergy and Infectious Diseases (NIAID; U01-AI35039, U01-AI35040, U01-AI35041, U01-AI35042, and UM1-AI35043), with additional co-funding from the National Cancer Institute (NCI), National Institute on Drug Abuse (NIDA), and National Institute of Mental Health (NIMH) at the National Institutes of Health (NIH). MACS data collection is also supported by UL1-TR000424 (JHU CTSA). The study funders had no role in study design, data collection, analysis, or interpretation, or writing of this report.
Publisher Copyright:
© 2019
PY - 2019/1
Y1 - 2019/1
N2 - Background: Lung disease is a common comorbidity in people with HIV/AIDS, independent of smoking status. The effects of marijuana smoking on risk of lung disease in HIV-infected individuals are unclear. Methods: In this prospective cohort study, we quantified lung disease risk among men enrolled in the Multicenter AIDS Cohort Study (MACS), a long-term observational cohort of HIV-infected and uninfected men who have sex with men. Eligible participants were aged ≥ 30 years with self-reported marijuana and tobacco smoking data from biannual study visits between 1996 and 2014. Pulmonary diagnoses were obtained from self-report and medical records. Analyses were performed using Cox models and Generalized Estimating Equations adjusted for tobacco smoking, CD4 T cell count, and other risk factors. Findings: 1630 incident pulmonary diagnoses were reported among 1352 HIV-seropositive and 1352 HIV-seronegative eligible participants matched for race and baseline age (53,794 total person-visits, median follow-up 10.5 years). 27% of HIV-infected participants reported daily or weekly marijuana smoking for one or more years in follow-up, compared to 18% of uninfected participants (median 4·0 and 4·5 years daily/weekly use, respectively). HIV-infected participants had an increased likelihood of infectious or non-infectious pulmonary diagnoses compared to uninfected participants (33·2% vs. 21·5%, and 20·6% vs. 17·2%, respectively). Among HIV-infected participants, recent marijuana smoking was associated with increased risk of infectious pulmonary diagnoses and chronic bronchitis independent of tobacco smoking and other risk factors for lung disease (hazard ratio [95% confidence interval] 1·43 [1·09–1·86], and 1·54 [1·11–2·13], respectively); these risks were additive in participants smoking both substances. There was no association between marijuana smoking and pulmonary diagnoses in HIV-uninfected participants. Interpretation: In this longitudinal study, long-term marijuana smoking was associated with lung disease independent of tobacco smoking and other risk factors in HIV-infected individuals. These findings could be used to reduce modifiable risks of lung disease in high-risk populations. Funding: U.S. National Institutes of Health.
AB - Background: Lung disease is a common comorbidity in people with HIV/AIDS, independent of smoking status. The effects of marijuana smoking on risk of lung disease in HIV-infected individuals are unclear. Methods: In this prospective cohort study, we quantified lung disease risk among men enrolled in the Multicenter AIDS Cohort Study (MACS), a long-term observational cohort of HIV-infected and uninfected men who have sex with men. Eligible participants were aged ≥ 30 years with self-reported marijuana and tobacco smoking data from biannual study visits between 1996 and 2014. Pulmonary diagnoses were obtained from self-report and medical records. Analyses were performed using Cox models and Generalized Estimating Equations adjusted for tobacco smoking, CD4 T cell count, and other risk factors. Findings: 1630 incident pulmonary diagnoses were reported among 1352 HIV-seropositive and 1352 HIV-seronegative eligible participants matched for race and baseline age (53,794 total person-visits, median follow-up 10.5 years). 27% of HIV-infected participants reported daily or weekly marijuana smoking for one or more years in follow-up, compared to 18% of uninfected participants (median 4·0 and 4·5 years daily/weekly use, respectively). HIV-infected participants had an increased likelihood of infectious or non-infectious pulmonary diagnoses compared to uninfected participants (33·2% vs. 21·5%, and 20·6% vs. 17·2%, respectively). Among HIV-infected participants, recent marijuana smoking was associated with increased risk of infectious pulmonary diagnoses and chronic bronchitis independent of tobacco smoking and other risk factors for lung disease (hazard ratio [95% confidence interval] 1·43 [1·09–1·86], and 1·54 [1·11–2·13], respectively); these risks were additive in participants smoking both substances. There was no association between marijuana smoking and pulmonary diagnoses in HIV-uninfected participants. Interpretation: In this longitudinal study, long-term marijuana smoking was associated with lung disease independent of tobacco smoking and other risk factors in HIV-infected individuals. These findings could be used to reduce modifiable risks of lung disease in high-risk populations. Funding: U.S. National Institutes of Health.
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U2 - 10.1016/j.eclinm.2019.01.003
DO - 10.1016/j.eclinm.2019.01.003
M3 - Article
C2 - 30854514
AN - SCOPUS:85064155900
VL - 7
SP - 55
EP - 64
JO - EClinicalMedicine
JF - EClinicalMedicine
SN - 2589-5370
ER -
